The present invention relates to electronic medical records used for storing clinically derived medical information about patients in a healthcare setting and in particular to an improved method of obtaining information from such electronic medical record systems.
Electronic medical record systems are computerized record-keeping systems intended to supplement or replace paper record systems in the healthcare environment. Such electronic medical record systems typically use a structured database holding a logical record for a given patient (for example, as may be represented as a row in a table) together with multiple data fields (for example, as may be represented as columns in the table). The values populating the data elements of the records and fields are collected by healthcare professionals to provide a comprehensive, reliable, and accurate view of the patient's health and medical treatment.
While such electronic medical record system databases often include text fields, for example, patient notes, their structured organization as a database ensures that the data of the database may be accessed in a deterministic manner to provide definitive information with respect to a given patient. For example, a review of an allergy report generated by a structured query of the structured database can be relied upon to provide an exhaustive, repeatable and comprehensive view of all the allergies of the patient contained in the structured database.
The structured organization also provides data that is readily machine readable (i.e. machine interpretable) because of the context information provided by the structure of the record fields and the known meaning of the fields. For example, the data of the structured database may be automatically reviewed by a computer (using a structured query) to accurately identify the allergies of a given population in the database, distinguishing, for example, “penicillin” as an allergy from “penicillin” as a treatment according to the record fields.
Such structured queries normally list data values together with record fields combined with Boolean operators and range operators.
The search of a structured database using a structured query search may be contrasted to “information retrieval” or text searches of a type familiar to users of search engines on the Internet. Such searches look for a text in text documents of largely unstructured text. The inherent imprecision in such searches is accommodated by presenting only a portion of the search results in ranked form according to statistical measurements. The results of a given search will vary over time as additional documents are added to the search space.
While such information retrieval searches can be extremely powerful, they are not comprehensive in the manner of a structured query of a structured database. For example, a search for the terms “osteoporosis” and “drugs” may yield useful information but cannot be relied upon to provide all or even the most relevant osteoporosis drug information. Further, because the text reviewed in a text search is normally not structured, the context or meaning of terms in the document may not be readily ascertained by the search engine. Thus, for example, a typical search intended to find drugs used for treatment of osteoporosis may also find drugs that exacerbate bone loss with use. Typically an information retrieval search cannot be considered exhaustive and some search terms may be disregarded as “noise” words and some relevant documents effectively discarded by low weighting.
The current promise of electronic medical record systems using structured databases is that they will substantially increase the efficiency and quality of healthcare by simplifying access to important medical data and providing a more comprehensive set of medical data. In this latter respect, the electronic medical record system can consolidate information collected by many different healthcare providers so that a physician, for example, has access not only to materials prepared by that physician but also information from other specialists, nurses, pharmacists and the like. Further, promised portability of the electronic medical records permits medical information collected about the patient to be preserved throughout the patient's life regardless of changes in physician or institution, offering greater longitudinal scope of medical information.
Current electronic medical record systems can produce a variety of useful reports that can present, compare, and even analyze data for ready access by a physician.